Ultimate Automotive Locksmiths Service Booking Form

Please complete the below fields and send back ASAP to help speed up our service to you

ACTION 🎬*

JOB QUOTE

Customers Name
Business or Customers Name

SUBURB 🌏*
A. The suburb the vehicle will be located
or
B. If you are attending our shop please type "SHOP"

Job Address*

Phone*

KEY TYPE
NON REMOTE ( basic key no remote)REMOTE key (turn metal blade in lock to start remote to unlock door)TWIST PROX (plastic FOB key in dash or steering column turn to start press remote to open door)SLOT KEY (put key slot in dash press to start ,press remote to open door)PROXIMITY (key in pocket push to start pull handle or press remote to open door)

Car Make*
Please Choose from the drop down menu
Alfa RomeoAudiBMWCitroenChrystlerDaewooDaihatsuDodgeFiatFordGreat WallHinoHoldenHondaHyundaiHummerIsuzuJaguarJeepKiaLandroverLexusMazdaMercedesMiniMitsubishiNissanPeugeotPorscheProtonRange RoverRenaultSaabSkodaSeatSsangyongSubaruSuzukiToyotaVWVolvoKawasakiHonda BikeSuzuki BikeTRUCKOther

YEAR MODEL
PRE 1997199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020

Car Model

Number Plate*

Date Preferred for Service to be Provided*

Job Description*
please tick the box that most suits the problem you are having

Keys Locked in Car Lost Key (no working keys) Broken Key Immobilizer Issue Spare Key Key Won't Turn in the Ignition Lock Key Wont Turn in the Door or Boot Lock Key Turns but will not start the car Other

Extra Information if Required
Please include a brief description of the work required

Please fill out below if you require an EXTRA, SPARE or HAVE LOST ALL KEYS

"Remote Keys" (press button on the key to unlock the door)
If you require new REMOTE keys please tick a box

0 1 2 3 4 5 6

"Non Remote Keys" (manual turn in the door lock only)
If you require new" NON REMOTE" keys please tick a box

0 1 2 3 4 5 6

Payment Type*

Quote Only Cash Eftpos Visa / MasterCard Account (approved Trade Customers)

Payment notes
please advise if payment is to be arranged by a 3rd party

Pictures if Required
Please attach pictures from your computer or smartphone's gallery that will assist in your request.

Email

Disclaimer*
I hereby Authorise a Representative of Ultimate Locksmiths to

(1)gain entry and Reproduce keys if Required.

(2)And/or carry out repairs as discussed to the Above vehicle and agree that I am

(a) the registered owner
or
(b) an authorised representative on behalf of the registered owner.

I agree the vehicle has No working keys and is unable to be inspected for any Electronic or Mechanical Faults or defects prior to the keys being replaced.

V.I.N Number (if available)
Found on the cars compliance plate or Rego/Insurance papers ect
17 letters and Numbers

Send me a copy of my responses

Email address

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